Skin Lesions (visual)

Skin Lesions and Disorders

Macule

  • Definition: Flat, colored area less than 1 cm.

  • Examples: Freckles, black moles, petechiae.

Papule

  • Definition: Elevated, less than 1 cm.

  • Examples: Warts, elevated moles.

Patch

  • Definition: Flat, non-palpable, irregularly shaped.

  • Examples: Port wine stains, Mongolian spots (common in infants).

Plaque

  • Definition: Elevated, firm with a rough, often blacktop surface.

  • Example: Plaque psoriasis, keratosis.

Wheal

  • Definition: Elevated, irregularly shaped, with edema and possible erythema.

  • Size: Variable.

  • Causes: Allergic reactions, insect bites.

Nodule

  • Definition: Elevated, firm, deeper than a papule.

  • Size: Usually 1-2 cm.

  • Example: Lipoma.

Tumor

  • Definition: Larger lesion than a nodule, solid and deeper into the dermis.

  • Types: Benign tumors, neoplasms, lymphomas, hemangiomas.

Vesicle

  • Definition: Elevated, superficial, filled with serous fluid.

  • Examples: Chickenpox, shingles.

Bulla

  • Definition: Larger blister, also filled with serous fluid.

Pustule

  • Definition: Elevated lesions filled with purulent fluid (pus).

  • Examples: Acne, impetigo.

Cyst

  • Definition: Elevated, encapsulated lesion in dermis/subcutaneous layer.

  • Example: Sebaceous cyst.

Telangiectasia

  • Definition: Fine irregular lines due to capillary dilation.

  • Causes: Sun exposure, prolonged standing, aging, skin trauma.

  • Associations: Common in alcoholics, smokers, or with conditions like Crohn's disease, scleroderma, lupus, and liver disease.

Scale

  • Definition: Flaky, dry skin.

  • Causes: Drug reactions, dermatitis.

Lichenification

  • Definition: Thickened, rough epidermis from chronic dermatitis.

  • Location: Common on flexor surfaces (ankles, elbows).

Keloids

  • Definition: Thick scars that exceed boundaries of original wound.

Scar

  • Definition: Fibrous tissue replacing normal skin post-injury.

Excoriation

  • Definition: Abrasion or scratch of the skin.

Fissures

  • Definition: Cracks in the skin (e.g., athlete's foot).

Erosion

  • Definition: Loss of part of the epidermis after a vesicle ruptures.

Ulcer

  • Definition: Also known as pressure injury, involves loss of both epidermis and dermis.

  • Characteristics: Varies in size.

Crust

  • Definition: Dried serum, blood, or pus.

  • Example: Seen in impetigo.

Atrophy

  • Definition: Thinning of skin, appears translucent and paper-like due to aging.

Pressure Injuries

Stage One Pressure Injury

  • Definition: Intact skin with non-blanchable redness.

Stage Two Pressure Injury

  • Characteristics: Partial thickness loss of dermis, shallow open injury.

  • Treatment: Hydrofiber, aqua cell, debriding agents like Santyl, transparent dressings (Upsalite, Tegaderm).

Stage Three Pressure Injury

  • Characteristics: Full thickness tissue loss into subcutaneous fat.

  • Notes: Bone, tendon, and muscle not exposed; may have undermining or tunneling.

Stage Four Pressure Injury

  • Characteristics: Full thickness loss with exposed bone, tendon, cartilage, or muscle.

  • Risks: High risk for osteomyelitis; often includes undermining and tunneling.

Unstageable Pressure Injury

  • Definition: Full thickness loss covered with slough or eschar.

  • Notes: Depth cannot be determined until base is exposed.

Suspected Deep Tissue Injury

  • Characteristics: Intact skin with purple/maroon color.

  • Condition: Soft tissue damage, feeling mushy or boggy.

This visual aids differentiation of skin lesions and understanding of pressure injury stages.